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Developmental Health Psychology

Developmental Health Psychology. Aging. Primary Aging “normal” senescence Secondary Aging “pathological” senescence. Health during old age. Most in good health (Stats Can., ’99) Most common chronic conditions: late adulthood Arthritis, rheumatism – 42% High blood pressure – 33%

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Developmental Health Psychology

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  1. Developmental Health Psychology

  2. Aging • Primary Aging • “normal” senescence • Secondary Aging • “pathological” senescence

  3. Health during old age • Most in good health (Stats Can., ’99) • Most common chronic conditions: late adulthood • Arthritis, rheumatism – 42% • High blood pressure – 33% • Allergies – 22% • Back problems – 17% • Heart problems – 16%

  4. Key ideas • Women live longer than men • But more likely to have chronic conditions and limitations in activities of daily living • Physical health declines, psychological well-being improves

  5. Determinants of health • Health beliefs, behaviours, social structure, SES • Often can be changed to improve health

  6. Despite attention paid to sickness and treatment, self-care is the most predominant form of care

  7. Mental Health • Attempt to live meaningfully • in a particular set of social and environmental circumstances • relying on a particular collection of resources and supports

  8. Self-development • self-perception • integration of various roles • striving for growth • possible commitment to something beyond self • Life satisfaction (self image, self esteem)

  9. Threats to mental health • Epidemiological Catchment Area Study • US Nat’l Inst. of Mental Health • 18,000 structured interviews • 5 regions across US • Dispelled 2 major myths: • Women at greater risk. • Older adults at greater risk

  10. Age-Related Trends in Mental Disorders • Lower prevalence in older than younger adults • all mental disorders (excluding dementias) • Younger (18-64 years): 11-25% • Older (65+): 6-14%

  11. Mood disorders (including depression) • Younger: 3-8% • Older: 2-3% • Dementia • Older: 6-10% • Possible co-existence and interaction with physical illness

  12. Are Elderly Less Prone to Mental Illness? • Diagnostic criteria not “age fair” • depression symptoms different in elderly • Elderly typically visit physicians before mental health professionals • physical symptoms mask psychological ones • e.g., difficulty sleeping, changes in diet, heart palpitations (depression)

  13. Myths, stereotypes about aging • must distinguish normal aging from disease • ageism in treatment • Cohort effects: “stigma”

  14. Alzheimer’s Disease • Progressive, degenerative brain disorder • Loss of memory, awareness, ability to control body functions

  15. First reported in 1907 • Shrinkage of cortex • Large masses of amyloid plaques • Spherical protein deposits outside of nerve cells • Neurofibrillary tangles • Twisted protein filaments inside neurons • Spread from bottom (midbrain) to top (cortex)

  16. Plaques, tangles present in normal aging brain • In Alzheimer’s: excessive, interfere with communication between neurons

  17. Prevalence • Rare under 50 • 6-10% over 65 • 30-50% over 85

  18. Symptoms • Permanent forgetting of recent events • Unable to do routine tasks • Forget simple words • Confusion in familiar locations • Forget what numbers mean • Put things in inappropriate places • Watch in fishbowl

  19. Rapid, dramatic mood swings • Loss of language, communication skills

  20. Causes • Very little known • Possibly: • Genetic factors (permitting tangles to form) • Environment (sporadic AD – no family history; possible toxins) • Build up of plaques in body, free radicals in brain

  21. Risk Factors • Age • Family history • Brain damage (accident) • Predictors: Kentucky Nun Study • “richness” of early writing

  22. Treatment • Anti-oxidants • Enzyme-blocking agents (prevent plaques) • Genetic engineering (promote neuron growth) • Respite care: caregiver stress • Behaviour Modification (activities of daily living)

  23. Physical activity • Social involvement • Good nutrition • Calm structured environment

  24. Coping with AD • Patient • Aware of changes • Shame, self image, fear of desertion • Behavioural changes (stages) • Caregiver: physical, psychological, social • 70% family members (female usually) • 50% severe stress

  25. Caregiver Stress • Physically exhausting: constant vigilance • Psychological effects • Grief: adjust to gradual loss • Increasing social isolation • Stigma: cover-up, try to avoid social interactions • Stress: severity depends on availability of social support (respite care, counselling, support groups)

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